They
have to report to the Health Secretary on 18 February 2008 so please
write well before then to give them time to take your views into account.

We're
not doing a standard letter this time because individual letters,
however short, count so much more. Common sense tells us that the
new proposals will result in tragically unnecessary deaths; and we're
sure everyone will have a personal reason why they believe services
should be maintained. We'd love you to tell the IRP your reasons.

Here are some thoughts which may add weight to your letter:

All
86 local GPs concluded the original proposals were "unsafe
and inhumane" - and thevast
majority of local GPs concluded the "revised" proposals
were not significantly different to the original

We're
not like other proposals the IRP have reviewed. Our critical difference
is that we're a semi-rural, semi-urban community. Unlike the other
proposals they've looked at, we haven't got another hospital on
our doorsteps. The delay caused by the journey to Oxford is just
too great - there will be deaths as a result

The
Stakeholder Panel, set up by the Trust to review the revised proposals,
concluded "The proposals represent a significant downgrading
of access to services and a worsening of choice for women and
children in the Banbury area

Nationally,
moves to downgrade children's services have been opposed by the Children's
Surgical Forum who called for the downward trend of paediatric surgery
at district general hospitals to be 'halted and reversed', with provision
of sufficient workforce to ensure service needs. It adds that health
reforms must not jeopardise the provision of safe, local care for
children, care must not be subject to 'market forces' and it 'feels
strongly that national action is required to secure safe services
locally'

The
Banbury branch of the Royal College of Midwives have expressed their
support for maintaining the full range of maternity and paediatric
services at the Horton, saying that they do not consider the changes
to be the safest option when compared with the present service

The
Horton gained 24 hour childrens services and consultant-led maternity
decades ago, after a tragic death occurred. All that has changed since
then is the population has grown and traffic has worsened. So how
can it be safe to remove these services?

If the proposals go ahead, the Horton will be one of the biggest midwife
led units in the country, and also one of the furthest away from consultant
support.

The
shortening of specialist training, at the same time as the full
introduction of European Working Time Directive and blocking
of training posts to non EU graduates are at the root of the
problem, which will destroy many small general hospitals like
the Horton.

Nonetheless,
other European countries appear to have resolved the problem
of the EWTD, where smaller consultant-led units remain the norm
- the JR maternity unit is already larger than
the largest units in Germany, Belgium, France and Holland.

The
government is within their rights to apply for a derogation
from the EWTD, at least until 2012, but has chosen not to do
so (in plain English - the government could choose to delay,
instead of reducing doctor's hours now, but aren't doing so)

Nationally
training needs are being put before service delivery.

The
government has the power to remove the above restrictions and
save small general hospitals across the country.

Independent
studies have shown that it could take up to 5 hours to transfer
a sick child from Banbury to the JR

An
ambulance takes around 40 minutes door to door. That's a guaranteed
40 minutes delay to life saving treatment

160
women per year are expected to be put through the trauma of
ambulance transfer when something goes wrong during labour.
An inter-unit transfer takes on average, 2.8 hours

Although
the Trust deny it, we fear that the removal of obstetric and
24 hour paediatric services will inevitably lead to the running
down of other services, such as A&E, in the future

Letters
to the IRP and government

Stakeholder
Group's report published

After
many months of meetings, reviewing and questioning reams of complicated
evidence, the stakeholder group has published its response to the working
groups' recommendations. Our representative on the panel, and Banbury
Town Council's representative, worked extremely hard to ensure that
the views of the Keep the Horton General Campaign - and by extension,
the views of the general public - were properly represented in the final
report, and they have done a superb job.

It
must be remembered that the report reflects the views of a diverse group,
not all of whom remain as opposed to the proposals as we do. However
we are pleased that the majority of those on the panel remain against
the proposals on the basis that the Trust has not done all that it can
to look at alternative ways of sustaining the current pattern of services
at the Horton.

The
group states "We have found ourselves being asked to choose
between the lesser of two evils - on the one hand there are the clinical
risks inherent in the current service arrangements;" (*)
"on the other there are the proposals that by addressing
the clinical risk will worsen access to services for local people"
(*due to changes in national policy on medical
training and the European Working Time Directive)

The
report goes on, "The proposals that the clinical working
groups have put forward may be a ‘least worst’ scenario
but they represent a significant downgrading of access to services and
a worsening of choice for women and children in the Banbury area. We
expect the Trust Board to take note of our comments to this effect before
making their decision.

We
are aware, however, that the Trust Board may decide anyway to go ahead
with the proposals from the clinical working groups. For this reason
we have made recommendations about how we think the proposals could
be enhanced and improved.

It
is important to note this should not be taken to mean that we support
them and that our comments and recommendations should only be read in
this context"

The report then lists 21 recommendations that
the group considers should be implemented to strengthen the proposals,
if the Trust ignores the stakeholders' opinion and goes ahead with the
changes.

The
stakeholder group recognises that the reasons for the changes are national
changes in medical education and the implementation of the European
Working Time Directive. However, as the report states "(this)
seems to us to be missing the point – health services must be
designed in the best interests of patients and education and training
should support that objective. Instead in Oxfordshire and other parts
of England educational concerns are leading decisions about the pattern
of healthcare with patient needs coming second." The report
goes on to say that the "ORHT has a duty to raise this
matter at a national level and challenge the rationale for these policies."

The
report is also highly critical of the way in which the working groups
and trust undertook the review, and raises concerns about the potential
for the "domino effect" damaging other vital services at the
Horton, such as A&E.

There is a “new” set of draft proposals on the table.As
a member of the Stakeholder Panel, we’ve seen them – and
we can tell you they are not substantially different to those put forward
last time.
The local GPs met on June 13, but as yet have been unable to decide
their response due to the inherently complex nature of the problem.
The GPs are probably the most influential body in the eyes of the ORH
Trust, so their opinion matters a great deal. Last year, 85 of them
described the Trust’s proposals as “unsafe and inhumane”,
and this is one of the main reasons that the Trust were forced to go
back and review their position.

It is vital to the success of the campaign that the
GPs maintain their solidarity, and ensure that the Trust know how bitterly
opposed the people of Banbury are to any paring down or withdrawal of
services at the Horton General Hospital.

So – if you think the children in the Banbury area deserve round-the-clock
care; if you think our women deserve a safe, consultant led maternity
service; and if you are worried that the paring down of these services
might have a knock on effect on other services such as A&E –
we need you to send a letter to your GP telling them so. We’ve drafted a letter for you which you can download
here.
Of course, if you are able to write a personal letter to your GP that
would be even bettere.

Please pass the letter onto anyone that you know who might send it,
or copy it and hand it out at school, work or church.

But above all – please sign and send it RIGHT NOW! Most GPs surgery
addresses are listed on our sample letters
page

__________________________________________________________

The
Trust's proposals have now been condemned by all the local stakeholders
in the consultation process. Medical professionals, the scrutiny committee,
politicians, civic leaders, religious groups, business groups and of course
the general public are UNITED in rejecting the proposed cuts.

The
Keep the Horton General Campaign response and appendices
You will not be surprised to learn that we believe the proposals will
have a significant detrimental effect on the services provided to the
people of North Oxfordshire and surrounding areas. We reject the Trust’s
proposals in their current form, but would welcome the chance to work
with them openly and honestly to find a solution that provides a safe,
sustainable service for the people of the Banbury area.

(The appendices form an integral part of the report and
must be read in conjunction with it.
The response has been split for ease of downloading)

General Practitioners response
(167k)
The GPs of North Oxfordshire & South Northamptonshire describe the
proposals as unsafe and inhumane, and accuse the Trust of intransigence,
lack of imagination or vision, misinformation, and more.The GPs opinion
carries a lot of weight, so this should be a big blow to the Trust!

Cherwell District Council's
response (2.7mb)
Comprehensive and damning, Cherwell District Council's report is well
supported by figures disproving some of the fundamentals of the Trust's
consultation document
Horton Midwives (letter below)The Horton Midwives have spoken out with great courage against
the Trust's proposals for the Horton's maternity service.

MPs response
Tony Baldry MP has joined with neighbouring MPs including David Cameron
to submit a joint response.

Support
from South Northants District CouncilWe
welcome the response from SNDC, who represent the 30,000 South Northants residents
in the Horton's catchment area.

________________________________________________________

The Oxford Radcliffe Hospital Trust's Consultation Document
This is what it's all about, and there's a summary on page 20 of Part
2. You should read it because you need to comment on it to be part of
the consultation exercise. But read between the lines - and remember the
source.

Whatever they are saying about "improvements" to services -
they are talking about improvements for Oxfordshire as a whole, not the
Banbury area. With the exception of elder care, there is no way any of
these proposals are improvements to people in North Oxfordshire, South
Warks or South Northants. You WILL see a reduction in the way YOUR heath
care is delivered.

There
are many errors in the report, some of which are listed below. Please note
that claims that womens' and childrens' services are not clinically sustainable
are highly suspect as there are reports that refute this - but the ORH Trust
will not recognise them in this consultation.

AS GENERAL
practitioners working in the area served by the Horton Hospital, we are writing
to express our grave concern at the proposals being put forward by the Oxford
Radcliffe Hospitals Trust to downgrade the range of services at the Horton
Hospital.

The immediate
threat is to round-the-clock paediatric services, which in turn will mean
that the maternity hospital can no longer continue to provide consultant-led
obstetric care.

This would
entail the transfer of most maternity work to the already overcrowded John
Radcliffe Hospital, with a minority of births – currently estimated
at 600 out of 1,600 – taking place in a midwife-only unit in Banbury.
There would be no medical cover for this unit closer than the John Radcliffe
Hospital.

Our present
midwifery service at the Horton has been described by ORT as an award-winning
service. It provides choices for women to either deliver in a unit run by
midwives and supported by obstetricians, paediatricians and neonatal nurses
on site, or to deliver at home with the knowledge that help is very close
by.

The proposed
new system will reduce choices for women and runs counter to the spirit of
increased choice.

A similar
scheme was put in place at Kidderminster when the local hospital was downgraded
in a similar way. "Low-risk" births continued at the Wyre Forest
Birth Centre with frequent transfers of mothers in labour to the consultant-led
service at Worcester, about 15 miles away. In less than two years, there were
six unexpected neo-natal deaths and the unit was subsequently closed following
a public enquiry. Similar
problems occurred within months at Bishop Auckland when a consultant-led obstetric
was closed down.

The risk
to and distress of mothers undergoing an ambulance transfer taking over an
hour in the late stages of labour is unacceptable. Still worse is the scenario
of a baby delivered at Banbury who is in need of immediate medical attention
and who has to be rushed to Oxford with only the most elementary resuscitation
en route, and who dies or suffers brain damage as a result.

This is
the most serious threat to health services that Banbury has faced. Only a
few years ago, the Davidson Inquiry carried out a comprehensive review of
local health needs and concluded that the Banbury locality needs its general
hospital, including 24-hour paediatrics.

We cannot
support the ORHT proposals, which would remove or severely undermine services
essential to the residents of our community, particularly the vulnerable.
They are unsafe.

The North
Oxford and South Northants GP Forum (A
group representing local GP Practices)

Full
24 hour childrens' services were ruled essential in Banbury after the tragic
death of a young child in 1974. The letter that follows is from his parents
to Trevor Campbell Davis, chief executive of Oxford Radcliffe Hospitals Trust.

THIRTY-TWO
years may seem a long time to some people, but we as a family can assure you
that time does not heal quickly.

We refer,
of course, to the loss of our son, Ian, through actions at the Horton General
Hospital on February 25, 1974.

As you
will be aware or advised, his loss – along with other factors –
directly attributed to the lack of paediatric facilities at that time at the
Horton. You will also have been advised that Ian’s was not the only
child death at the hospital at that time; another had occured a few months
previously.

Part of
the recommendations of a public inquiry set up after Ian’s death was
that there should be full 24-hour paediatric facilities at the Horton –
and common sense prevailed at that time, with this recommendation being implemented.
What has now changed that you consider these facililties are no longer required?

It now
appears that with an ever-increasing population in the Banbury area that the
decision is that a reduced paediatric facility is acceptable at our local
hospital.

Well, we
believe that you should never revert to a system that is able to allow history
to repeat itself.

We appeal
to you not to proceed with the transfer of any paediatric service or even
any service from this hospital to any of the Oxford hospitals.

Mr and
Mrs D LuckettAddress
supplied

Letter
from the Horton midwives

Some
of the Horton midwives have bravely spoken out in protest at the cuts. Their
letter, published in the Banbury Guardian on 8 June, really brings home the
full extent of women who will be forced to go to the JR. There is also a cleverly
worded letter from the Midwife Managers in the following week's paper which
emphasises that of course the midwives will continue to provide the best care
they possibly can - and that's the point. The midwives, not
the consultants, will provide the care, and that means all
the reductions outlined in the original letter by the midwives.

Letter from the Horton midwives to the Banbury Guardian, 8th June 2006

"WE
WISH to make it known to the people of Banbury that the overwhelming majority
of midwives working at the Horton Maternity Unit adamantly oppose the changes
being proposed by the Oxford Radcliffe NHS Trust regarding the provision of
maternity services in the Banbury area.

We are dismayed
at the lack of consultation with staff and service users that has taken place
in the planning of these changes and believe that if the changes being put
forward are fully implemented, the safety of mothers and their babies in the
Banbury area will be compromised.

Limited details
of the proposed changes, including the possible use of ‘alternative’
therapies and provision of single rooms, have recently been published. While
these suggestions may seem appealing to many women the reality is that a midwife
led unit would only provide care for a select group of low risk women. This
would mean that a very large number of pregnant women in the Banbury area
who were not considered low risk would be excluded from using the service
and be left with no choice but to travel to the John Radcliffe Women’s
Centre in Oxford for their maternity care.

The following are
just a few of the reasons why a pregnant women would not be allowed to use
the birth centre:

In addition, women
who did use the birth centre would not have access to the following procedures:

- No caesarean
sections, emergency or planned
- No doctors available to carry out forceps or ventouse deliveries
- No paediatrics available to resuscitate and treat babies.
- No epidurals
- No blood transfusions- No induction
of labour- No Special
Care Baby Unit.

Women in labour
requiring any of the procedures or services would have to endure an ambulance
journey of more than 30 minutes to the John Radcliffe, with no guarantee that
an ambulance would be immediately available to transfer them.

The John Radcliffe
Women’s Centre is already operating at full capacity and no extra provision
of facilities for the increased numbers of women who will need to be transferred
from the Horton have yet been put into place.

Pregnant women
in the Banbury area who wish to give birth in a midwife led unit already have
the choice of using the excellent birth centre facility at Chipping Norton
Hospital. We
feel that an additional midwife led unit in Banbury is unnecessary and greatly
limits the amount of choice for pregnant women in the area.

We need a safe,
caring, appropriately funded obstetric unit in Banbury to provide local women
with the level of choice and care they deserve.

We hope that the
people of Banbury will support us and speak out against the proposed changes"